If Juggernauts are not supposed to be long-ranged and instead have a hard time closing in on enemies, why does Nasus have a long-ranged 99% slow that makes it super easy for him to get closer to his enemies?

The complexities and ambiguities of productivity measurement should not discourage managers from using a system. Profit measures, after all, are also far from perfect, but we are accustomed to their shortcomings and have learned how to glean a wealth of insight from them. Managers should proceed with productivity measures, but with care. The seriousness of a system’s shortcomings depends on how it is used; if bonuses or promotions are based on certain measures, they had better be accurate. But this degree of accuracy is unnecessary for most applications.

Perhaps the most important use of productivity measurement is as an objective source of information about long-term operating trends. An index can draw attention to plants or departments experiencing unusual problems or uncommonly strong performance. Productivity comparisons can also inspire useful exchanges of ideas. Differences in the amount of vertical integration or subcontracting, accounting policies, and many other factors often obscure the relative productivity of companies. Nonetheless, if a business finds itself a lot less productive than a competitor, it probably has a real problem. Managers may insist that the productivity gap is overstated, and they may be right. They will be hard-pressed, however, to argue that it does not exist.

W. Bruce Chew
is a senior consultant at Monitor Company, a global consulting firm in Cambridge, Massachusetts. He is a former associate professor of technology and operations management at the Harvard Business School in Boston, Massachusetts.

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You can also easily measure employee productivity using time tracking software. We use Yaware.TimeTracker, it shows if the employee spend time productively, and as a result allows to eliminate time-eaters. http://timetracker.yaware.com/measuring-employee-productivity-at-ease

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Sinus Infections That Don’t Quit: When You Should Worry

Most of us know the discomfort and annoyance of a sinus infection. Especially when they linger on. But few people realize that there are rare cases when untreated sinus infections can turn serious. Advertising Policy Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse …
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Most of us know the discomfort and annoyance of a sinus infection. Especially when they linger on. But few people realize that there are rare cases when untreated sinus infections can turn serious.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.
Policy

The first thing to realize is that all
sinus infections
are not the same. A sinus infection, a.k.a. sinusitis, can be either a viral or bacterial infection. The term “sinusitis” simply means that there’s irritation in your sinuses, which make up the lining around the air spaces between bones that surround your nose.

Ear, nose and throat specialist
Raj Sindwani, MD,
says the only way to know whether it’s a cold or a bacterial infection in the early stages is to swab inside the nose and grow a culture. “This is rarely necessary because sinusitis often goes away by itself,” Dr. Sindwani says. “But if it hangs on, you want to see your doctor.”

Symptoms of the different strains are so similar that doctors typically recommend patients wait seven to 10 days before seeking treatment. Viral infections — the common cold — usually work themselves out in that period of time with nothing more than liquids, rest and perhaps
Tylenol
, Dr. Sindwani says.

“If you don’t get better, we start thinking there’s a bacterial component,” he says. “That’s when we pull the trigger on an antibiotic.”

The main reason to prescribe antibiotics is for patient comfort, Dr. Sindwani says. The medical field used to be more convinced than it is today than
untreated sinusitis
would inevitably become a chronic issue, he says.

“We don’t think that way as much,” he says. “We don’t know that an untreated acute sinusitis, if left untreated, will grumble along and cause people to have a chronic sinus infection.”

“Some people think that’s two separate things,” with chronic sinusitis more likely due to “underlying issues like allergies or immune problems.”

Antibiotics also can help ward off rare but potentially dangerous complications that arise when a sinus infection spreads to the eyes or brain, Dr. Sindwani says.

A thymocyte's fate is determined during positive selection. Double-positive cells (CD4
+
/CD8
+
) that interact well with MHC class II molecules will eventually become CD4
+
cells, whereas thymocytes that interact well with MHC class I molecules mature into CD8
+
cells. A T cell becomes a CD4
+
cell by down-regulating expression of its CD8 cell surface receptors. If the cell does not lose its signal, it will continue downregulating CD8 and become a CD4
+
, single positive cell.
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But, if there is a signal interruption, the cell stops downregulating CD8 and switches over to downregulating CD4 molecules, instead, eventually becoming a CD8
+
, single positive cell.

This process does not remove thymocytes that may cause
autoimmunity
. The potentially autoimmune cells are removed by the process of negative selection, which occurs in the thymic medulla (discussed below).

Negative selection removes thymocytes that are capable of strongly binding with "self" MHC peptides. Thymocytes that survive positive selection migrate towards the boundary of the cortex and medulla in the thymus. While in the medulla, they are again presented with a self-antigen presented on the MHC complex of medullary thymic epithelial cells (mTECs).
[36]
mTECs must be
+
to properly express self-antigens from all tissues of the body on their MHC class I peptides. Some mTECs are phagocytosed by thymic dendritic cells; this allows for presentation of self-antigens on MHC class II molecules (positively selected CD4
+
cells must interact with MHC class II molecules, thus APCs, which possess MHC class II, must be present for CD4
+
T-cell negative selection). Thymocytes that interact too strongly with the self-antigen receive an
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signal that leads to cell death. However, some of these cells are selected to become cells. The remaining cells exit the thymus as immature
naïve T cells
(also known as recent thymic emigrants
[37]
). This process is an important component of
central tolerance
and serves to prevent the formation of self-reactive T cells that are capable of inducing autoimmune diseases in the host.

In summary, β-selection is the first checkpoint, where the T cells that are able to form a functional pre-TCR with an invariant alpha chain and a functional beta chain are allowed to continue development in the thymus. Next, positive selection checks that T cells have successfully rearranged their TCRα locus and are capable of recognizing peptide-MHC complexes with appropriate affinity. Negative selection in the medulla then obliterates T cells that bind too strongly to self-antigens expressed on MHC molecules. These selection processes allow for tolerance of self by the immune system. Typical T cells that leave the thymus (via the corticomedullarly junction) are self-restricted, self-tolerant, and singly positive.